Exercise Myoglobinemia and Acute Exertional Rhabdomyolysis

Demos, Michael A.; Gitin, Eugene L.; Kagen, Lawrence J.

doi:10.1001/archinte.1974.00320220071007

Cited by 101 publications

(17 citation statements)

References 13 publications

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“…This opinion is consistent with local and regional studies, which find that CKD appears more common among occupations where strenuous work undertaken at high ambient temperatures is typical [9-13,28,29]. Although not a recognized cause of CKD, heat stress is associated with volume depletion and may also be associated with muscle damage (rhabdomyolysis), both of which may predispose individuals to AKI, particularly in the presence of nephrotoxic medications [26,27,30,31]. Critically, there is a growing body of literature that suggests that AKI, even if mild or if the serum creatinine recovers to baseline, may result in residual structural damage and ultimately progress to clinically recognized CKD [32-36] (See Figure 1).…”

Section: Discussionsupporting

confidence: 85%

Chronic kidney disease in Nicaragua: a qualitative analysis of semi-structured interviews with physicians and pharmacists

et al. 2013

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BackgroundNorthwestern Nicaragua has a high prevalence of chronic kidney disease (CKD) of unknown cause among young adult men. In addition, frequent occurrence of urinary tract infections (UTI) among men and a dysuria syndrome described by sugarcane workers as “chistata” are both reported. This study examines health professionals´ perceptions regarding etiology of these conditions and their treatment approaches, including use of potentially nephrotoxic medications.MethodsNineteen in-person semi-structured interviews were conducted in November 2010 among ten physicians and nine pharmacists practicing in the region.ResultsHealth professionals perceived CKD as a serious and increasing problem in the region, primarily affecting young men working as manual laborers. All interviewees regarded occupational and environmental exposure to sun and heat, and dehydration as critical factors associated with the occurrence of CKD. These factors were also considered to play a role in the occurrence of chistata in the region. Health professionals indicated that reluctance among workers to hydrate might be influenced by perceptions of water contamination. Symptoms often were treated with non-steroidal anti-inflammatory drugs (NSAIDs), diuretics and antibiotics. Physicians acknowledged that the diagnosis of UTI usually was not based on microbial culture and opined that the use of potentially nephrotoxic medications may be contributing to CKD.ConclusionsInterviews provided evidence suggesting that medications such as diuretics, antibiotics and NSAIDs are widely used and sold over the counter for symptoms that may be related to dehydration and volume depletion. These factors, alone or in combination, may be possible contributors to kidney damage. Acute kidney damage coupled with volume depletion and exposures including medications and infectious agents should be further evaluated as causal factors for CKD in this region.

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Section: Discussionsupporting

confidence: 85%

Chronic kidney disease in Nicaragua: a qualitative analysis of semi-structured interviews with physicians and pharmacists

et al. 2013

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“…Although renal failure is a potentially serious complication of rhabdomyolysis, studies by Kearns et al, 11 Sinert et al, 12 and Demos et al 13 have reported that high levels of serum CPK/myoglobin from upper-extremity exertion does not usually lead to renal failure, as was in our case. These results can be helpful in counseling and discussing the possible complications of rhabdomyolysis with patients and may be a useful tool in the clinical decision-making process of whether to manage a patient in the hospital (high CPK levels in the presence of other nephrotoxic factors such as aciduria and hypovolemia) or closely as an outpatient (minimal pain, normal creatinine/electrolytes, and with reliable follow-up).…”

Section: Discussionsupporting

confidence: 60%

Exertional Rhabdomyolysis in Seven Division-1 Swimming Athletes

Galvez¹,

Stacy²,

Howley³

2008

Clinical Journal of Sport Medicine

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“…Injury to skeletal muscle, secondary to severe physical exercise, can result in rhabdomyolysis (12). Myoglobinemia is a sensitive sign of muscle injury (23,39).…”

Section: Resultsmentioning

confidence: 99%

“…The degree of symptoms depends upon the runners' individual training condition prior to the race and their work intensity during the race (27,37). During a marathon, leakage of substances such as enzymes and myoglobin from muscles cells into the circulation, hemolysis, and leukocytosis occur frequently in the runners (12,13,23,25,30,33,36). However, controversial findings on the effect of physical exercise on muscle cell leakage, hemolysis, and leukocytosis have been obtained using trained or untrained subjects, and also according to the choice of magnitude of stress and of time of blood sampling after exercise (5-7, 19, 21, 24).…”

Section: Introductionmentioning

confidence: 99%

Indicators of Cell Breakdown in Plasma of Men During and After a Marathon Race

et al. 1988

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Plasma indicators of muscle cell leakage and of hemolysis were studied in 23 runners before and after a marathon race. Blood samples were drawn from an antecubital vein the morning before the race (baseline), at 3 p.m., i.e., 2 h before the start, on arrival, 12 and 36 h, and 7 days later. Compared with the baseline values, the plasma creatinine phosphokinase MM and MB subfractions, aldolase and glutamicoxaloacetic transaminase activity were increased immediately after the race, rose further 12 h after the marathon, and remained elevated the race, rose further 12 h after the marathon, and remained elevated 36 h and 7 days later. The plasma lactate dehydrogenase activity and myoglobin concentration were increased on arrival and returned to the pre-race activity 7 days after the marathon. Compared with the pre-race values, the plasma haptoglobin concentration was decreased immediately and 12 h after the marathon. Our data show that indicators of muscle cell leakage and of hemolysis in plasma, withdrawn after a marathon race, remained elevated for up to 7 days after the race.

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Exercise Myoglobinemia and Acute Exertional Rhabdomyolysis

Cited by 101 publications

References 13 publications

Chronic kidney disease in Nicaragua: a qualitative analysis of semi-structured interviews with physicians and pharmacists

Chronic kidney disease in Nicaragua: a qualitative analysis of semi-structured interviews with physicians and pharmacists

Exertional Rhabdomyolysis in Seven Division-1 Swimming Athletes

Indicators of Cell Breakdown in Plasma of Men During and After a Marathon Race

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